| NPI | 1326074576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN COX Practice Manager 843-766-6229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 19704) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: SC 19704) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2008-07-07 |